title: Laboratory investigation and follow-up of chronic kidney disease stage 3 in primary care.
abstract: BACKGROUND
  To explore how CKD stage 3 patients are examined and treated in primary care with emphasis on laboratory analyses.
  
  
  METHODS
  A total of 386 patients with CKD stage 3, and their physician (one patient per general practitioner (GP)) were selected from hospital laboratory databases. GPs received a questionnaire asking them to categorize their patients' renal function based on creatinine and eGFR results, denoting follow-up and what changes in creatinine and eGFR results were considered clinically important.
  
  
  RESULTS
  The response rate was 60%, and 210 patients were included. Patients' median creatinine values were 95 μmol/L (females) and 124 μmol/L (males), the median eGFR value was 52 ml/min/1.73 m2. Only 27% of patients were assessed to have CKD stage 3. 2/3 had either a urine dip strip (59%) and/or a urine albumin measurement (42%) and 20% were diagnosed with albuminuria. Median changes to signal improvement or deterioration in renal function or indicate referral were 14 (12%), 20 (18%) and 40 (36%) μmol/L for creatinine and 8 (17%), 8 (17%) and 13 (26%) ml/min/1.73 m2 for eGFR. Albuminuria did not influence follow-up strategy.
  
  
  CONCLUSIONS
  CKD stage 3 patients were insufficiently examined for albuminuria and seemingly referred to hospital care after larger eGFR declines than recommended in guidelines.
authors.affiliation: Laboratory of Clinical Biochemistry, Haukeland University Hospital, and The Norwegian Quality Improvement of Laboratory Services in Primary Care (NOKLUS), Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway. kristin.moberg.aakre@helse-bergen.no
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Aakre
authors.forename: Geir
authors.initials: G
authors.lastname: Thue
authors.forename: Einar
authors.initials: E
authors.lastname: Svarstad
authors.forename: Øyvind
authors.initials: Ø
authors.lastname: Skadberg
authors.forename: Sverre
authors.initials: S
authors.lastname: Sandberg
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003404:Creatinine / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D007753:Laboratories; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*
chemical_list: D003404:Creatinine